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DOI: 10.5999/aps.2012.39.5.470
Surgical Correction of Whistle Deformity Using Cross-Muscle Flap in Secondary Cleft Lip
Authors
This study was supported by research funds from Chosun University, 2008.
Background The whistle deformity is one of the common sequelae of secondary cleft lip deformities. Santos reported using a crossed-denuded flap for primary cleft lip repair to prevent a vermilion notching. The authors modified this technique to correct the whistle deformity, calling their version the cross-muscle flap.
Methods From May 2005 to January 2011, 14 secondary unilateral cleft lip patients were treated. All suffered from a whistle deformity, which is characterized by the deficiency of the central tubercle, notching in the upper lip, and bulging on the lateral segment. The mean age of the patients was 13.8 years and the mean follow-up period was 21.8 weeks. After elevation from the lateral vermilion and medial tubercle, two muscle flaps were crossed and turned over. The authors measured the three vertical heights and compared the two height ratios before and after surgery for evaluation of the postoperative results.
Results None of the patients had any notable complications and the whistle deformity was corrected in all cases. The vertical height ratios at the midline on the upper lip and the affected Cupid's bow point were increased (P<0.05). The motion of the upper lip was acceptable.
Conclusions A cross muscle flap is simple and it leaves a minimal scar on the lip. We were able to reconstruct the whistle deformity in secondary unilateral cleft lip patients with a single state procedure using a cross-muscle flap.
This article was presented at the 1st Research and Reconstructive Forum on May 12-13, 2011 in Daejon, Korea.
Publication History
Received: 09 May 2012
Accepted: 01 August 2012
Article published online:
01 May 2022
© 2012. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)
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REFERENCES
- 1 Guerrero-Santos J, Ramirez M, Castaneda A. et al. Crossed-denuded flap as a complement to the Millard technique in the correction of cleft lip. Plast Reconstr Surg 1971; 48: 506-508
- 2 Trussler AP, Kawamoto HK, Wasson KL. et al. Upper lip augmentation: palmaris longus tendon as an autologous filler. Plast Reconstr Surg 2008; 121: 1024-1032
- 3 Song T, Yin N, Li H. et al. Bilobed mucosal flap for correction of secondary lip deformities following cleft lip surgery. J Plast Reconstr Aesthet Surg 2011; 64: 589-594
- 4 Grewal NS, Kawamoto HK, Kumar AR. et al. Correction of secondary cleft lip deformity: the whistle flap procedure. Plast Reconstr Surg 2009; 124: 1590-1598
- 5 Kim SW, Park SO, Choi TH. et al. Change in upper lip height and nostril sill after alveolar bone grafting in unilateral cleft lip alveolus patients. J Plast Reconstr Aesthet Surg 2012; 65: 558-563
- 6 Henkel KO, Gundlach K, Saka B. Incidence of secondary lip surgeries as a function of cleft type and severity: one center's experience. Cleft Palate Craniofac J 1998; 35: 310-312
- 7 Patel IA, Hall PN. Free dermis-fat graft to correct the whistle deformity in patients with cleft lip. Br J Plast Surg 2004; 57: 160-164
- 8 Chen PK, Noordhoff MS, Chen YR. et al. Augmentation of the free border of the lip in cleft lip patients using temporoparietal fascia. Plast Reconstr Surg 1995; 95: 781-788
- 9 Kapetansky DI. Double pendulum flaps for whistling deformities in bilateral cleft lips. Plast Reconstr Surg 1971; 47: 321-323
- 10 Juri J, Juri C, de Antueno J. A modification of the Kapetansky technique for repair of whistling deformities of the upper lip. Plast Reconstr Surg 1976; 57: 70-73
- 11 Matsuo K, Fujiwara T, Hayashi R. et al. Bilateral lateral vermilion border transposition flaps to correct the "whistling lip" deformity. Plast Reconstr Surg 1993; 91: 930-935
- 12 Guerrero-Santos J. Use of a tongue flap in secondary correction of cleft lips. Plast Reconstr Surg 1969; 44: 368-371
- 13 Yoshimura Y, Nakajima T, Nakanishi Y. et al. Secondary correction of bilateral cleft lip deformity with simultaneous Abbe flap and nasal repair. J Craniomaxillofac Surg 1998; 26: 17-21
- 14 Jackson IT, Soutar DS. The sandwich Abbe flap in sceondary cleft lip deformity. Plast Reconstr Surg 1980; 66: 38-45
- 15 Niechajev I. Lip enhancement: surgical alternatives and histologic aspects. Plast Reconstr Surg 2000; 105: 1173-1183
- 16 Coleman SR. Facial recontouring with lipostructure. Clin Plast Surg 1997; 24: 347-367
- 17 Wakami S, Harada T, Muraoka M. et al. Rectangular mucosal flap with artificial dermis grafting for vermilion deformity in cleft lips. J Plast Reconstr Aesthet Surg 2010; 63: 22-27
- 18 Cho BC, Kim SW. Philtrum formation in secondary unilateral cleft lip and microform cleft lip using vertical interdigitation of the orbicularis oris muscle. J Korean Soc Plast Reconstr Surg 2004; 31: 279-286
- 19 Millard DR. Discrepancies in muscle continuity and philtral contour. In: Millard DR. Cleft craft. The evolution of its surgery I: the unilateral deformity. 1976. 1st ed. Boston: Little Brown; 545
- 20 Randall P, Whitaker LA, LaRossa D. The importance of muscle reconstruction in primary and secondary cleft lip repair. Plast Reconstr Surg 1974; 54: 316-323